Devices are available in the prior art for stabilizing endotracheal tubes or the like which are inserted in the nose or mouth of a patient. In particular, these devices have been developed for use with babies which can exhibit a significant amount of head movement which might otherwise dislodge or extubate the tube. There are many such examples of these devices found in the prior art.
Of those known to the inventor, U.S. Pat. No. 4,867,154 discloses various embodiments of an endotracheal tube stabilizing device which is perhaps most closely related to that of the present invention. In the '154 patent, a framework is supported by a three-point mounting, the forehead and the two zygoma regions (cheekbones) of a framework generally extending over the face of the patient. Various shapes for the framework are suggested, with the framework being attached by Velcro.TM. pads and taped to the patient's face. As can be appreciated, the framework is suggested as being quite substantial and a tube holder or adapter is secured to the framework through which the endotracheal tube is inserted.
As suggested by most of the prior art, the '154 patent continues the general approach in the prior art of providing a substantial framework which was thought to be necessary in order to secure the endotracheal tube to prevent its being accidentally extubated by the thrashing about of a patient. Unfortunately, these frameworks are undesirable in that if applied to a premature baby or younger infant, they can block the view of the baby's face and cause undue alarm to the baby's parents. Furthermore, these frameworks obscure the baby's face and restrict access to the baby's face for any medical procedures such as suctioning or the like. Furthermore, the frameworks are generally custom-made which increases their expense and also requires that they be sized appropriately for different patients.
In order to solve these and other problems in the prior art, the inventor herein has succeeded in designing and developing an elegantly simple arrangement for stabilizing an endotracheal tube which offers minimal interference with access to the patient's face, and which is also minimally obtrusive to the patient's face (and therefore aesthetically more pleasing). Essentially, the arrangement of the invention includes utilizing a single strand of K-wire which has its ends secured to adhesive patches, such as moleskin, the patches being applied near the baby's ears. The K-wire is sized to extend immediately below the baby's nose or at the level of the mouth, as required, and is simply secured to the endotracheal (or other) tube with a suture or with a small strip of adhesive tape. As compared with the endotracheal stabilizing devices of the prior art, the present invention presents a significant improvement in several different areas. First of all, K-wire can be cut to an appropriate length from available stocks of K-wire, and moleskin patches may be used from available stocks of moleskin such that no special apparatus, patches of Velcro.TM., frameworks, or the like are required in order to form the present inventive arrangement. Consequently, the present invention represents a significantly smaller cost and completely eliminates any requirement of inventory of different sized devices. While providing minimal interference with access to the baby's face, the device has been found to be more than capable of holding the endotracheal tube in place as the baby thrashes about. Additionally, by eliminating the significant structure found in other prior art devices, the present invention actually minimizes the potential for injury to an infant.
The moleskin patches attaching the ends of the K-wire may be properly oriented upon application to put the K-wire adjacent a tube inserted in the nose or the mouth, as desired. Thus, the same device may be utilized for either while in the prior art different devices were typically used. This feature exhibits the versatility of the present invention. Furthermore, as the moleskin patches are placed proximal to and anterior to the ears, a wider base of support is provided than those prior art devices which secured a supporting framework on the face of the patient, such as in the '154 patent. This placement also prevents loosening of the moleskin due to a baby's salivation, which is the major problem currently encountered in the commonly used practice of taping the tube to the perioral area.
While standard K-wire may be utilized and is shown in the preferred embodiment, non-metallic or non-magnetic "wires" may be utilized instead such that the device will not interfere with MRI imaging scanners or the like. The "wire" need only be sufficiently malleable and long enough to be properly oriented over the patient's face.
Still another feature of the device is the ability to effectively "mark" the position on the tube whereat the K-wire is positioned so that replacement tubes, or the replacement of tubes which have been extubated for any reason, may be positioned at exactly the same place. This thereby decreases the need for subsequent radiographs to verify placement of the tube. In addition, reintubation does not require removal of the device, unlike any existing stabilizer.
While the principal advantages and features of the invention have been explained above, a more thorough understanding may be attained by referring to the drawings and description of the preferred embodiment which follow.